Individual provider · Type 1 NPI
Mandy Elizabeth Bettenhausen, AGNP
Gerontology Nurse Practitioner · St. Louis, MO
NPI number
1295254266
Active
Practice location
4901 Forest Park Ave, Div Surg Accs, Ste 340
St. Louis, MO 63108-1495
Fax (888) 824-2176
Mailing address
660 S Euclid Ave, Msc 8109-43-1160
St. Louis, MO 63110-1010
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 2019008105 (MO) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1295254266
Mandy Elizabeth Bettenhausen, AGNP's National Provider Identifier is 1295254266, issued on Sep 11, 2017. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in St. Louis, MO. The record was last updated on Aug 23, 2023.